BlueEdge HSA Plan
BlueEdge HSA Overview
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BlueEdge Individual HSA plans are priced among the lowest of Blue Cross Blue Shield of Illinois' major medical health insurance plans, while still covering the same health care services as the more expensive PPO plans.
Key BlueEdge HSA® plan features include:
- Individual deductibles ranging from $1,200 to $5,000
- Individual maximum out-of-pocket expenses ranging from $3,000 to $5,000
- Family deductibles ranging from $2,400 to $10,000
- Family maximum out-of-pocket expenses ranging from $6,000-$10,000
- Medical services and surgical expenses
- Accident and emergency care
- Preventive care and wellness for adults and children, up to $300 per calendar year maximum per member
- Childhood immunizations up to the child’s sixth birthday
- 3 tier prescription drug copay formulary ($10 / $50 / $65) after deductible
- Optional dental coverage
- 24-Hour Worldwide Care
- $5,000,000 lifetime maximum
BlueEdge HSA® may be right for you if you are an individual or family who:
- Want affordable premiums and need a wide range of benefits
- Don’t expect to have a lot of medical expenses
- Have money saved just in case you have to pay unexpected out-of-pocket health care expenses
- Are looking for more control over your health care choices
BlueEdge HSA uses the BlueChoice® Network: The BlueChoice® network allows you to save on premiums and the cost of covered services when you use a contracting BlueChoice® hospital, doctor or specialist. You do not need to select a primary care physician or obtain a referral to see a specialist.
Compare the features, options and costs of BlueEdge HSA® plans to find the one that's right for you.
Learn more about valuable member services and features you get when you join the Blue Cross and Blue Shield of Texas family.
BlueEdge HSA Costs
BlueEdgeSM Individual HSA provides different levels of out-of-pocket expense limits, deductibles and coinsurance to allow you to select the plan that best meets your budget. With BlueEdgeSM Individual HSA, here’s what you can expect:
- PPO benefits begin after you meet the deductible
- Coinsurance level determined by health insurance plan selection
- Individual deductibles ranging from $1,200 to $5,000
- Individual maximum out-of-pocket expenses ranging from $3,000 to $5,000
- Family deductibles ranging from $2,400 to $10,000
- Family maximum out-of-pocket expenses ranging from $6,000-$10,000
- Copayments ranging from 75–100 percent of allowable amount after calendar year deductible for office visits (doctor consultation only) and emergency care
- Coinsurance — you pay 0–25 percent of allowable amount and the health insurance plan pays 75–100 percent of allowable amount
By using a contracting BCBS PPO hospital, doctor or specialist you are able to save on premiums and the cost of covered services. You do not need to select a primary care physician or obtain a referral to see a specialist.
For more information on costs, get a quick quote or see the outline of coverage 
.
What's Included with BlueEdge HSA®
- BlueEdgeSM Individual HSA pays 75–100 percent of allowable amount and you pay 0–25 percent of allowable amount for covered expenses after you meet your deductible (in-network).
- In-network doctor’s office visits for routine physicals, immunizations and diagnostic tests are covered at 75–100 percent of the allowable amount, subject to deductible, with a $300 calendar year maximum per participant.
- Easy claims processing—no forms to file in most cases
- Emergency room visits are covered at 75–100 percent of allowable amount after calendar year deductible and coinsurance.
- The tax-favored advantages that come with a Health Savings Account
- Access to online decision tools to help increase your knowledge of health issues and track your health care expenses
Prescription Drug Coverage
For the BlueEdge HSA plans, there is a prescription drug card benefit that includes a $10 copay for generic, $50 copay for preferred, and $65 copay for non-preferred drugs after you reach your deductible.
If you take medications for birth control, high blood pressure, cholesterol, or other long-term needs, there is a Home Delivery prescritpion benefit where you can receive a 90 day supply in the mail for the cost of a 60 day supply at retail. You may also fill a 90-day supply at a retail pharmacy and in some cases, you may pay less than filling three 30 day supplies.
For the BlueEdge HSA 100% coinsurance plans ($3,500 or $5,000 individual deductible), there is no prescription copay after the medical deductible is reached and prescriptions are paid at 100%.
| Outpatient Prescription Drug Benefit | You Pay | BlueEdge HSA Pays |
| Retail Pharmacy Up to a 30-day supply. |
||
| Generic | $10 co-payment | 100% |
| Preferred Drugs | $50 co-payment | 100% |
| Non-Preferred Drugs | $65 co-payment | 100% |
| Home Delivery Up to a 90-day supply of maintenance drugs is available through home delivery. |
||
| Generic | $20 co-payment | 100% |
| Preferred Drugs | $100 co-payment | 100% |
| Non-Preferred Drugs | $130 co-payment | 100% |
| Calendar Year Maximum | There is a $5,000 calendar year maximum for each member whether or not benefits are received at a participating pharmacy, non-participating pharmacy, or through the mail service prescription drug program. | |
To see if your prescriptions are included, view the individual health insurance plan Preferred Drug List .
Plan Renewals
Your BCBSTX policy can ONLY be terminated for the following reasons:
- Failure to pay
- The plan is discontinued (90 days notice given with an option to convert to any plan we offer)
- Discovery of fraud or an intentional misrepresentation of facts (30 days prior written notice given)
- If you no longer reside, live or work in an area where we are authorized to do business
Optional Dental Plan
The Individual Dental Indemnity plan is available as an optional benefit with your individual Blue Cross Blue Shield of Texas Select health insurance plan. There is an additional premium.
Some of the highlights of Dental Indemnity USA coverage include:
- Covers oral exams, cleanings, fluoride treatments, sealants, x-rays, and other preventive procedures immediately with no waiting period
- A $50 individual and $150 family deductible, based on fee schedule allowances, applies for dental procedures or services received by a covered individual during each benefit year
- $1,000 benefit per person per year
- $1,000 orthodontia lifetime maximum benefit per person
- Covered individuals must be enrolled for 12 months before receiving dental benefits in these categories; major restorative, periodontics, removable prosthetics, fixed bridge and orthodontia.
See the complete dental outline of coverage for more details on covered benefits.